Awake Brain Surgery

Awake brain surgeries play a significant role in the treatment of neurological diseases. These surgeries offer great advantages, particularly in treating sensitive and functional areas of the brain. In these procedures, where the patient is awake, surgeons can directly observe the effects on the brain and make necessary interventions while preserving neural functions.

The Basics of Awake Brain Surgery

Awake brain surgery is a procedure that requires the patient to be conscious while the surgeon intervenes in specific areas of the brain. It is commonly used in the treatment of diseases such as epilepsy, brain tumors, and movement disorders (such as Parkinson’s disease). These surgeries are performed with great care to avoid disrupting the functions of sensitive regions of the brain during the intervention.

Methods of Awake Brain Surgery

Awake brain surgeries generally consist of two stages:

1. Pre-surgical Preparation and Anesthesia: At the beginning of the surgery, the patient is administered local anesthesia, which numbs only the scalp, allowing the patient to remain conscious. However, relaxing medications are given to reduce the stress the patient may feel during the operation.
2. Surgical Intervention and Brain Mapping: The awake patient is asked some questions or instructed to perform specific movements. This process helps the surgeon test the patient’s brain functions and identify which regions need to be addressed. The surgeon ensures that critical areas such as the motor cortex, language processing regions, or sensory areas are not damaged.
   • Brain Mapping: In awake brain surgeries, electrodes are used to map the functional regions of the brain. These electrodes measure the brain’s electrical activity and identify which areas control specific functions. This allows the surgeon to determine which regions can be intervened with minimal damage.

Applications of Awake Brain Surgery

1. Epilepsy: Removal of epileptic foci in the functional area with this method improves the quality of life in patients with resistant epilepsy.
2. Brain Tumors: Awake brain surgery is used when surgical removal of brain tumors located in functional areas is necessary. In such surgeries, surgeons monitor the patient’s responses to minimize damage and ensure optimal intervention.
3. Parkinson’s Disease and Other Movement Disorders: In treating Parkinson’s disease, deep brain stimulation (DBS) can be applied to specific brain regions. During awake brain surgery, the patient’s motor functions are tested to apply electrical stimulation to the correct areas.
4. Functional Mapping of the Brain: During awake brain surgery, it is important to map the functional areas of the brain and preserve functional connections. Awake brain surgeries enable the successful execution of such delicate procedures.

Advantages and Risks

Advantages:

• Preservation of Functional Regions: Awake brain surgeries allow surgeons to intervene in critical regions of the brain without causing damage.
• Real-Time Feedback: The patient’s feedback during surgery enables the surgeon to assess the effects on the brain instantly.
• High Success Rate: When performed correctly, these surgeries have a high success rate in patients’ recovery processes.

Risks:

• Anxiety and Stress: Being awake during the surgery can increase the patient’s anxiety levels, especially before the procedure.
• Brain Inflammation or Bleeding: Direct intervention on the brain may lead to infections, bleeding, or other complications.
• Loss of Neural Functions: Despite all technological advances and experience, in some cases, temporary or permanent neurological function losses may occur.

 Awake brain surgery is a revolutionary approach in the treatment of neurological diseases. It offers a significant advantage in preserving neural functions when intervening in sensitive areas of the brain and optimizing patients’ recovery processes. However, these surgeries require high expertise and constitute an important skill set for surgeons. While risks remain, technological advancements have made these procedures safer, presenting a vital option for improving the quality of life for many patients.